Any problems with Mercury Pharma Levo? - Thyroid UK

Thyroid UK
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Any problems with Mercury Pharma Levo?

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I have just replied to a query about Mercury Pharma Levo causing stomach problems .I am taking 100 mcgs MP and am suffering from aching muscles .....my legs being the worst.I'm beginning to question whether it's my medication upsetting me and would be interested to know if anyone else is having this problem whilst taking Mercury Pharma tablets?

61 Replies
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Hi. Despite checking that the MP levo had the same excipients as Eltroxin, after a month or so on their generic I didn't feel so good and I started having headaches. I've taken this opportunity to go over completely to NDT (I was taking 2 gr + 50 mcgs t4). Been a week, and feel much better and my years of muscle aches in back / legs are feeling much easier.

helvella
helvellaAdministrator in reply to Banjogirl

AmCo's statement on the lack of difference between Eltroxin and MP levothyroxine (for professionals) is available here:

amcolimited.com/media/309/H...

If anyone believes it is not the same, then appropriate complaints should be made. The only variation that seems possible within what they say is any ordinary batch-to-batch variation which can always occur.

Rod

Banjogirl
Banjogirl in reply to helvella

Hmmmmmmn. I read what they say but I definitely wasn't doing as well on the unbranded levo. I checked it all out beforehand thinking it would be fine. But, it wasn't. At least for me.

helvella
helvellaAdministrator in reply to Banjogirl

If what they say isn't true, they deserve many tons of bricks flying at high velocity towards them.

If it is true, what on earth does it mean?

The MHRA have suggested that we might learn more somewhere around the middle of November.

Rod

What is NDT? And is it prescribed by you doctor?

Hidden
Hidden in reply to veronicahoward

I think perhaps you meant to reply to banjogirl ....it's all confusing!

Also known as NT (Natural Thyroid) or NDT (Natural Desiccated Thyroid)

Comes from the thyroid gland of pigs. The glands are dried and ground into a powder that is combined with binders and fillers and is pressed into pill form.

Contains both of the main thyroid hormones, T4 and T3

May contain other hormones (T1, T2, calcitonin)

The natural thyroid brands manufactured in the United States include:

Nature-throid and WP Thyroid (made by RCL Labs)

Armour Thyroid (made by Forest Labs)

NP Thyroid (made by Acella Labs)

And in Canada, Thyroid (made by Erfa Canada Inc.) Compounding pharmacies can also used the raw ingredient (USP Thyroid Powder) to fill an RX to a doctor’s specifications.

As for being prescribed by my GP - I wish ! :) but he knows and approves of my taking NDT and agrees that clinical diagnosis of how well you feel is what counts, not lab results - (my tsh is suppressed and ft3/4 all at high end of range - most GPs blood pressure would be through the roof at the very thought!!!! :)

helvella
helvellaAdministrator in reply to Banjogirl

More information- including ingredients - available here:

thyroiduk.org.uk/tuk/treatm...

Rod

Hidden
Hidden

Thanks Banjogirl....that is interesting.I shall query it with the Endo I am seeing next week.X

Banjogirl
Banjogirl in reply to Hidden

Actually meant to say I was on MP generic levo for 4-5 months. Gradually felt worse over time with headaches. Didn't have a problem with eltroxin over 10+ years. Like I said, a good reason for me to swap to NDT.

Like you Banjogirl I have been on Eltroxin for over 20 years with no adverse effects, then came this and the chemist suggested liquid Eltroxin, which is described on the bottle as levothyroxine and I have used it for about 30 days until the problem regarding the shortage is resolved. I now, for the first time in years do not feel well. I am a retired teaching lawyer and our MP is currently investigating with the Minister for Health.

The chemist is referring to my doctor and the doctor is referring me back to the chemist and the chemist says the shortage of eltroxin derives from the wholesalers who, in turn blame the manufacturers. I suspect that profit is the motive and if this is so then the Trading in Medicines regulations kick in. This document contains criminal sanctions.

Can you say what NDT stands for and does your doctor prescribe it?

For the last 3 months i have been taking mp levo ,and have been getting a rash (really itchy)thought maybe on to high a dose but have no other symtoms ,(before this i took the levo from that pharmaceutical that stopped making levo,can not remember there name at the moment brain fog)

Hidden
Hidden in reply to Lizzy1606

I agree, last few months have had headaches aches and pains and more tiredness, also have had urticaria for past 2 years, not sure if thats when mercury pharma took over from the previous company ( sorry the name escapes me),lts hard to know what to do for the best.

helvella
helvellaAdministrator in reply to Hidden

Mercury Pharma is the name chosen by Goldshield when they decided to re-name themselves. That was not a takeover.

Rod

helvella
helvellaAdministrator in reply to Lizzy1606

Do you by any chance mean Teva?

Rod

Hidden
Hidden in reply to helvella

Sorry ......wrong use of words. Eltroxin Goldshield became Mercury Pharma.

I haven't taken TEVA since the early years following being diagnosed in 2002 before changing to Goldshield Eltroxin, which I was happy with.The only other brand I've had was Actavis when my GP forgot to write Eltroxin on my prescription.

Muscular aches have always been a problem for me whilst on thyroxine but have worsened this year....a fibromyalgia test was negative.

Danifox6
Danifox6 in reply to Hidden

Fibro test?!!? What did that entail??

Hidden
Hidden in reply to Danifox6

Sorry for the delay in replying Danifoxq....first chance I've had today! However, Fibromyalgia test was just a normal blood test and result was just reported negative for me.

Danifox6
Danifox6 in reply to Hidden

That what they said to me, but surely negative can also mean you are ok??

Hidden
Hidden in reply to Danifox6

I can't say I'm OK as I'm struggling with aching muscles,but the fibromyalgia test was negative.Perhaps my Endo will help me find out what the problem is next week.

Marz
Marz in reply to Hidden

The test done by Rheumatologists is to check that you have at least 14 matching painful points when pressed - throughout the body. Had it done around 14 years ago - so could have the number wrong - maybe its 13 out of 18 points. If the point on the right shoulder is painful then there needs to be a matching one on the left side....

HiddenThis reply has been deleted
Marz
Marz in reply to Hidden

I didn't mention any blood test ....

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Marz
Marz in reply to Hidden

...in that case then you have to click onto Marfit for her to receive your post..... :-) ;-)

Hidden
HiddenAdministrator in reply to Marz

Don't you just 'love' 'reply to this' confusions..!? :(

L

x

Marz
Marz in reply to Hidden

xx

Hidden
Hidden in reply to Hidden

Hi Louise....you are as amused as I am..... M X

Lizzy1606
Lizzy1606 in reply to helvella

No Mercury Pharma

helvella
helvellaAdministrator in reply to Lizzy1606

I meant Teva as the company that stopped making levothyroxine. :-)

Mercury Pharma still do so.

Hidden
Hidden in reply to helvella

Thanks Helvella.......I have just found a book during some reorganising of shelves that we can't remember buying! " The Thyroid Solution" by Ridha Arem,M.D.....Have been reading the chapter on Treating the Underactive Thyroid P 253......have to bear in mind that he is a professor of medicine in America,but reading about synthetic generic levothyroxine being used instead of named brands is all very disturbing and leaves me wondering how reliable and stable the dosages are here in UK.Perhaps we have grounds to be concerned about our prescriptions.It all needs a lot of understanding.I believe the book is in thyroid UK's lending library.If I bought this book some years ago ,I was probably completely lacking in knowledge and totally confused at that time anyway.

helvella
helvellaAdministrator in reply to Hidden

The USA situation is very different to ours.

Synthroid, their top selling brand, is expensive. So there has long been pressure to supply something else. There has also been lots of pressure from patients to use almost anything else than Synthroid!

The FDA has tightened up significantly on the standards for all levothyroxine products in the past decade or so.

Despite that, the Levoxyl brand, formerly number two to Synthroid, is off the market due to some problems.

Some patients have found the Unithroid product (also sold as Lannet) has actually suited them better than either of the two big brands. Another patient posted they were doing very well on Mylan generic.

We in the UK have only two formulations at each dosage. We simply do not have the generic/named issue. Every levothyroxine tablet in the UK is generic - but is almost always in a clearly labelled blister pack.

The MHRA was absolutely clear in their report that levothyroxine is a difficult product. That the standards need to be updated to include dissolution. That at least some of the Teva product (when it was available) failed to deliver the claimed dose.

We too have had a tightening of potency a few years ago.

Not for one minute am I saying all is wonderful in the garden. But I don't think it is as bad as the worst of the USA market twenty years ago.

Rod

Hidden
Hidden in reply to helvella

Thanks for your comments and sharing of knowledge.It does all get very confusing and I think maybe we sometimes read too much in our search for answers to our problems.

I myself now have 5 books on the subject!

However,I am seeing an Endo next week so am hoping he will help to me to manage my own situation.He comes recommended, so I will report in due course on how I get on.

Hidden
Hidden

Eltroxin was the previous company.With them I was only on 50mcgs My increase to 100mcgs was with Mercury Pharma.

Headaches and muscular weakness are mentioned in their possible side effects list.I am glad to be seeing an Endo to try to sort things out. My legs are really aching badly.

helvella
helvellaAdministrator in reply to Hidden

The possible side effects identified in the Patient Information Leaflets for Mercury Pharma Eltroxin and Mercury Pharma Levothyroxine are almost identical. Specifically on the ones you mention.

The PILs are available here:

medicines.org.uk/emc/defaul...

Rod

Banjogirl
Banjogirl in reply to helvella

Strange then, that possible side effects only showed up with the MP generic and not the previously used branded Eltroxin as reported here and elsewhere on the internet. Makes you wonder ........... :)

helvella
helvellaAdministrator in reply to Banjogirl

Yes - it is strange. Deeply strange.

The whole issue is odd and riddled through with a lack of clarity.

If they are the same, why is Eltroxin not available?

The 25mcg tablets actually have the same marketing authorisation (used to be product license) number in both Eltroxin and Mercury Pharma. So I believe that they are absolutely, 100% identical. Umm, so why are they not available as Eltroxin?

How come someone got some Eltroxin tablets very recently (and posted here about them) with an expiry 08/2015? Which would strongly suggest recent manufacture and delivery to market.

Rod

I suspect that MP have a small on going production of Eltroxin to be supplied only on demand/complaint about the cheaper generic. Am I right in thinking that by law they cannot completely withdraw supply of a drug without a specific withdrawal time being allocated. ? Given the market competition for manufacturing t4, withdrawing Eltroxin and substituting cheaper generic may grab them a bigger slice of market. Oh cynical me!

helvella
helvellaAdministrator in reply to Banjogirl

There really isn't much competition within the UK.

Only two companies supply each dosage. If it's 25 mcg it's Wockhardt or Mercury Pharma. If it's 50 or 100 mcg it's Actavis or Mercury Pharma.

I don't see why withdrawing Eltroxin would increase Mercury Pharma's market share or profit - but that could be me not seeing something really obvious. :-)

Rod

Banjogirl
Banjogirl in reply to helvella

Because with parallel importing it allows non uk generics into uk prescription market. :)

helvella
helvellaAdministrator in reply to Banjogirl

There aren't any non-UK Levothyroxine tablets except Wockhardt. Mercury Pharma most certainly have assured us their levothyroxine products are made within the UK only. :-)

Tiggertighe
Tiggertighe in reply to helvella

If Eltroxin has lost its patent (and accompanying premium price) it would be in MP's interest to manufacture its own generic (levo) to protect and maintain its market share and thereby minimise its loss in profits. I can't see how they can increase profits with their generic levo but at least they will have a chance to keep some of the Eltroxin business vs other generic companies.

helvella
helvellaAdministrator in reply to Tiggertighe

Any patent on Eltroxin (if indeed there ever was one) is dead by many decades.

To make their own generic might make sense. But to make it to exactly the same formulation and for the NHS to continue to buy the Eltroxin at a slightly higher price is a strange situation.

Rod

Tiggertighe
Tiggertighe in reply to helvella

Indeed it is Rod :)

Wonder if there was a deal to be had?

Diane.

Well, one could ponder every which way the reasons for Eltroxin disappearing from the market or the validity of MP's claims that their generic is an identical replacement. It is a matter of pure conjecture that

profiteering might be involved. :) ha ha!

Mercury Pharma levothyroxine gave me really bad muscle pains. I didn't get this with Actavis levo. I had been increasing my dose and was given MP 25mcg tablets to add to my dose. I became really unwell so tried cutting Actavis 50mcg tablets in half instead and the pains went away. I did try MP tablets again a couple of times but couldn't tolerate them so I think it must be something in the tablets - the only significant difference in the ingredients I could see is Acacia but I couldn't find anything to suggest it might cause muscle pain.

When did the name change please?

helvella
helvellaAdministrator in reply to Danifox6

Which name?

I suspect that you used Reply instead of Reply to this so your response is not below what you were responding to! If you see what I mean.

Rod

Hidden
Hidden in reply to helvella

I think there has been so many replies to this subject all day that I'm confused too.....not sure who is replying to who.

Danifox6
Danifox6 in reply to helvella

The name to Mecury Pharma :)

helvella
helvellaAdministrator in reply to Danifox6

2012.

See this page:

amcolimited.com/about/history

Rod

Hidden
Hidden

Wow! I have just opened my I Pad ....first time today and found 23 emails ...ie. replies from HU! I really did open a can of worms didn't I !

This subject looks like it could go on for ages but thank you to everyone who has discussed it here.I have to go out soon but will post a message when I get back.

HiddenThis reply has been deleted
Hidden
Hidden in reply to Hidden

I'm unable to comment on your own experiences.....I would need to ask at my surgery regarding the Fibromyalgia test and am not experiencing the same symptoms that you have since starting on MP Levo.My energy levels have improved since taking Vit B12 and Folic acid,I very rarely suffer headaches and my rings all still come off.However,the muscular aches are very real and I have other things to discuss next week at the Hospital.

I'm sorry though that you've had a bad time on the generic meds.It does seem strange that there is said to be no difference to the branded Eltroxin and yet there are so many people unhappy with the change.

As said before I will hopefully be able to get some help when I see the consultant and then feel able to report here.Have a good weekend.

Hi Marfit

I have been taking Levo 100mcgs for just over 5 months, was on 50s before and pretty much since i started I have had problems with a burning sensation in my stomach, feels almost like an ulcer, have told my GP who says this cannot be the levo and that I should try a course of acid reducing tablets, ozmyprol i think they are called, pretty sure when i first started Levo i was on a different brand to the ones currently on which are made by Mercury Pharma, has anyone else got any suggestion I have found a chemist that stocks a different brand and was thinking of giving this a go. at my wits end with it all, never had problems with stomach acid before starting these tablets. Thanks Fish

sassicat
sassicat in reply to fish77

From my own experience one suggestion is that with the increased dose of thyroxine your stomach is work more efficiently and producing more acid which will be painful until the levels of protective mucosa catch up. I found that when I was hypo my stomach acid became very low, causing digestive problems and food intolerances, mainly to wheat. I found that taking a betaine hydrochloride supplement really helped. After being diagnosed with hypothyroidism and starting thyroid replacement my levels of stomach acid very quickly increased which was quite painful. This soon resolved as my stomach adjusted to the higher levels. I no longer needed to take the digestive enzymes and after a few months all food intolerances dissapeared. In recent months due to problens with Eltroxin I have become very hypo again and the problem of low stomach acid and food intoletances is returning. You could try lowering the dose and then gradually increasing it. Perhaps by 1/4 tablet (25 ug) every two to three weeks. ... You can split the tablets :-)

sassicat
sassicat in reply to sassicat

P.S. Meant to say that to go from 50 to 100 mcg in one jump is a lot. Also I think that stomach irritation can be a 'hyper' symptom, so again a slighty lower dose may help.

danceforever
danceforever in reply to fish77

I was like that on a brand I tried 3 yrs ago, I felt all my insides burning all the time, and no it was not acid, it was the thyroxine. ask your pharmiasist if you can try a different brand, if they dont have any, then try another chemist until you find a brand that doesn't do that.

Hidden
Hidden

Unfortunately,I don't feel able to make any suggestions regarding your stomach problem especially regarding what to take for relieving it.However,I too feel that the discomfort increased with the raise in meds to 100 mcgs MP

I have experienced that acidic feeling and have tried leaving out various foods and drinking more water and less milky tea.leaving out bread seems to help.

Having seen an Endo just this afternoon,I am adjusting my medication down to alternating 100 with 75 in order to arrive at 87.5 mcgs.......an amount not available here in UK and am getting a blood test for T3 before I see him again as My T4 is at the top of the range but my TSH below range.I am really hopeful that he will be able to help me.

I wish you good luck in searching for a solution....Perhaps someone else will be able to help with suggestions.

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